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2022—2023年中国十省（自治区）老年居民身体活动与肌肉衰减综合征的关联

Relationship between physical activity and sarcopenia among elderly people in ten provinces (autonomous regions) of China, 2022—2023

    摘要
  • 摘要:
    背景 增龄导致的老年人身体活动量下降，可增加肌肉衰减综合征发病风险。目前尚缺乏基于大样本自然人群的身体活动与肌肉衰减综合征剂量-效应关系的研究。
    目的 探究中国10省（自治区）60岁及以上老年人身体活动状况与肌肉衰减综合征的关系。
    方法 数据来源于2022—2023年“中国发展与营养健康影响队列调查”。该调查采用问卷调查法收集个人基础信息和身体活动等数据，通过生物电阻抗法测量四肢骨骼肌质量，使用手持握力计测量骨骼肌力量，采用6 m步速测试反映骨骼肌功能。根据2019年亚洲肌肉衰减综合征工作组的推荐标准判断是否发生肌肉衰减综合征。计算每周低强度身体活动（LPA）、中高强度身体活动（MVPA）时间和总身体活动量。选取有完整数据的3326名60岁及以上老年人作为调查对象。利用多元logistic回归模型和限制性立方样条（RCS）分析不同强度身体活动时间和总身体活动量与肌肉衰减综合征的关系。
    结果 中国10省（自治区）60岁及以上老年人中肌肉衰减综合征患病率为5.5%（95%CI：4.7%~6.2%）。多元logistic回归结果显示，与LPA时间在0~7.0 h·周−1的老年人相比，LPA时间为>14.0~21.0 h·周−1的老年人肌肉衰减综合征患病风险降低51%（OR=0.49，95%CI：0.26~0.96）；与总身体活动量≥15.0 MET（代谢当量）-h·周−1的老年人相比，总身体活动量<7.5 MET-h·周−1的老年人肌肉衰减综合征患病风险增加了1.24倍（OR=2.24，95%CI：1.17~4.29）。RCS结果显示，每周LPA时间以及总身体活动量与肌肉衰减综合征患病风险均存在非线性剂量-效应关系（P总趋势<0.05，P非线性<0.05），与LPA 时间为0 h·周−1的老年人相比， LPA 时间达到12.6 h·周−1的老年人肌衰征患病风险降至最低（OR=0.42，95%CI：0.21~0.83）；与总身体活动量为15.0 MET-h·周−1的老年人相比，总身体活动量为46.0 MET-h·周−1的老年人发生肌衰征的风险降低了43%（OR=0.57，95%CI：0.38~0.84），每周MVPA时间与肌肉衰减综合征患病风险间的关联没有统计学意义（P>0.05）。
    结论 增加每周LPA时间和总身体活动量有助于降低肌衰征患病风险。

     

    Abstract:
    Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia.
    Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China.
    Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia.
    Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week−1 in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week−1 was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week−1, those with <7.5 MET-h·week−1 had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (Poverall<0.05, Pnon-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week−1, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week−1 was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week−1, the elderly with a total physical activity volume of 46.0 MET-h· week−1 had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05).
    Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

     

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